Author: Brianna Swyden

How’s Your Cholesterol Level? Why Your LDL Numbers May Not Tell the Whole Story

Posted on by Brianna Swyden

Ever since the 1960s, the world has been obsessed with cholesterol—and that’s especially true for LDL cholesterol.2 If you’ve been diagnosed with borderline high LDL levels (130-159 mg/dL) or high LDL levels (160-189 mg/dL), your doctor has likely suggested strategies for lowering your levels. The problem is, your LDL levels may not be the best indicator of your risk. In fact, approximately 10 percent of people with normal LDL have elevated levels of something called ApoB levels, a sign that you may still be at a higher risk of cardiovascular disease.3

What Is ApoB and Why Does It Matter?

ApoB—technically known as apolipoprotein B—is a large protein that’s found in all “bad” cholesterol particles, including low-density lipoprotein (LDL) and very low-density lipoprotein (VLDL). It plays a crucial role in transporting these harmful forms of cholesterol into your arteries, where it contributes to the formation of artery clogging plaque.4 Think of ApoB as the conductor guiding your cholesterol train, transporting harmful cholesterol into your arteries. Worse yet, this conductor only gives rides to harmful lipids, not the good cholesterol like high-density lipoprotein (HDL) that removes the bad cholesterol. Over time, these destructive lipids accumulate, contributing to atherosclerosis and increasing your risk of a heart attack or stroke.5 Research even suggests that ApoB levels are a more accurate predictor of a future cardiovascular events than LDL cholesterol or non-HDL cholesterol (the total amount of “bad” cholesterol in your blood).6

Testing 1,2,3

Fortunately, it’s easy to determine your ApoB levels via a simple blood test. What do the results mean? Normal levels of apolipoprotein B (ApoB) vary depending on factors such as age, gender, and individual health status but, according to general guidelines, healthy levels for men range from 66-133 mg/dL and for women 60-117 mg/dL. Levels over 133 mg/dL indicate an increased risk of cardiovascular disease. While some people with a family history of heart disease may have elevated levels, pregnancy, kidney disease, or having high total cholesterol and high LDL cholesterol can also result in higher than normal ApoB levels.7

How to Lower Your ApoB Levels

Even if your levels are high, you can lower ApoB, and it starts with your lifestyle. Adopting the  everyday changes discussed below can help to decrease both your ApoB and LDL cholesterol levels while also increasing your (good) HDL cholesterol levels.

Start with your diet. Eating a Mediterranean diet has been shown to lower ApoB levels. One study that appeared in the British Journal of Nutrition found that eating a Mediterranean diet for just four weeks decreased ApoB levels by 10 percent.8 Another study of 551 people at high risk of cardiovascular disease reported that adopting a Mediterranean diet reduced ApoB levels by 4.4 percent compared to a low-fat diet.9 High in olive oil, leafy greens, legumes, nuts, and fish, a heart-healthy Mediterranean diet is rich in soluble fiber and healthy unsaturated fats while being naturally low in fructose, as well as saturated fats and trans fats.

Add exercise. An observational study of more than 100 people found that those who exercised moderately for 30-60 minutes five days per week had a 14 percent lower ApoB compared to the sedentary participants.10 While aerobics can help lower your levels, it’s important to include resistance training like weight lifting, which has been shown to reduce ApoB levels by as much as 50 mg/dL over three months.11

Watch your weight. People who are overweight or obese are more likely to have high ApoB levels. This has been proven in studies showing a link between a higher body mass index (BMI), greater central obesity, and higher ApoB levels, with obese individuals at the greatest risk.12,13 Maintaining a healthy weight reduces the risk of elevated ApoB. The good news? Eating a Mediterranean diet and regularly working out can help you lose the weight and keep it off.

Soothe stress. Living a stressful life increases the stress hormone cortisol. That, in turn, can increase ApoB levels, as well as whole body inflammation.14 Although it’s impossible to avoid all stress, you can help manage the stress that does come your way by incorporating a few relaxation techniques into your daily life. Experiment with deep breathing, journaling, meditation, or yoga and see what works best for you.

Consider Supplements

Supplements alone won’t magically lower your ApoB levels. But pairing the following with the lifestyle changes above can help to reduce the negative effect this cholesterol conductor can have on your cardiovascular health.15

Aged garlic extract. This proprietary form of garlic has been the subject of numerous studies showing its ability to reduce the risk of heart disease on multiple fronts, from lowering blood pressure to slowing the progression of coronary artery calcification (CAC).16,17 But when aged garlic extract (AGE) is combined with vitamins B6 and B12, folic acid, and L-arginine, it also reduces ApoB. This was shown in a year-long clinical trial of 65 people at intermediate risk of heart disease. The participants were divided into two groups: one group took this proprietary combination of nutrients while the other took a placebo. At the end of the study, all the participants underwent coronary artery calcium scanning. Those taking the AGE supplement experienced less progression in the buildup of CAC , as well as a reduction in their total and LDL cholesterol. Plus, the AGE group also saw a significant decrease in ApoB.18

Plant sterols. Sterols, typically called phytosterols, are natural compounds found in plants that have a chemical structure similar to cholesterol. Because of this, they can help reduce your body’s cholesterol levels by competing with cholesterol for absorption in the gut. This effectively leads to less cholesterol entering the bloodstream. Better yet, these unique plant compounds also reduce ApoB.19 But if you think eating more sterol- and sterolin-rich grains, nuts, and veggies will do the trick, think again. Even those eating a plant-based diet would struggle to obtain enough of these phytosterols to move the cholesterol and ApoB needle. Instead, supplementing with these two compounds has been shown to efficiently lower both LDL and total cholesterol and ApoB.20,21

Red yeast rice. This unique compound is produced when a mold called Monascus purpureus colonizes and ferments rice. As the mold turns the rice dark red, it produces a medicinal compound called monacolin K that research shows it reduces LDL cholesterol as much as 25 percent.22 In 15 studies involving 8,000 participants, supplementing with this natural statin alternative decreased LDL and total cholesterol, with no damage to liver or kidney function.23 Another study of more than 1,000 people also found that red yeast rice significantly reduced ApoB.24

Knowing your ApoB levels could be the missing link for truly reducing your risk of a future heart attack or stroke. Lowering your ApoB levels with these healthy lifestyle changes and supplements can help you drive that cholesterol train toward healthier arteries and a lower risk of heart-related complications.

Heart-Healthy Workouts for Women

Posted on by Brianna Swyden

It’s no secret that exercise is good for your heart—but did you know that may be especially true for women? A 2024 study from the Smidt Heart Institute at Cedars-Sinai shows that women who work out get more cardiovascular benefit out of each minute of moderate to vigorous exercise than their male counterparts do.1 During the study, the researchers analyzed data from 412,413 adults utilizing the National Health Interview Survey database. The participants—55 percent of whom were women—provided information on their leisure-time physical activity, including the frequency, duration, intensity and type of activity they engaged in. They found that the mortality and cardiovascular benefits among the men maxed out at 300 minutes of moderate to vigorous exercise per week. The women, on the other hand, got the same benefit from just 140 minutes per week. And the women who worked out more (up to 300 minutes per week) experienced even greater cardiovascular benefits. (Yes, we know that these gals may be more of an exception than the rule. That said, it’s good to know that, even if you aren’t a gym rat, you can tone up your cardiovascular system—as well as your biceps—by exercising about half as long as the men in your life.)

Why Your Heart Loves Exercise

Adding regular physical activity to your daily routine can improve your cardiovascular health in multiple ways:

  • Improves overall cardiovascular health. Regular exercise can help strengthen the heart muscle, improves circulation, and lowers blood pressure, reducing the risk of heart attack and stroke.2
  • Boosts VO2 Aerobic exercise improves VO2 max—the maximum amount of oxygen the body uses during intense exercise. A higher VO2 max level is an indication of better cardiorespiratory fitness and cardiovascular health.3
  • Lowers cholesterol levels. Physical activity can raise levels of “good” HDL cholesterol and lower levels of “bad” LDL cholesterol, which can help prevent plaque buildup in the arteries.4
  • Weight management. Exercise can help women maintain a healthy weight, reducing the risk of obesity-related cardiovascular conditions.5
  • Reduces risk of diabetes. Regular physical activity can improve insulin sensitivity and help regulate blood sugar levels, lowering the risk of developing type 2 diabetes, which is a risk factor for heart disease.6
  • Stress reduction. Exercise can help reduce stress levels and improve mental well-being, which can have a positive impact on your cardiovascular system.7
  • Improves mood and sleep. Regular physical activity can boost mood, reduce anxiety and depression, and promote better sleep, all of which contribute to overall heart health.8,9
  • Enhances overall fitness. Exercise can improve endurance, strength, and flexibility, making daily activities easier and reducing the risk of injury.10

Many of these benefits have been highlighted in two large studies. The Nurses’ Health Study has followed more than 70,000 female nurses for nearly half a century and found that those who engaged in regular physical activity had a significantly lower risk of developing heart disease compared to those who were inactive.11 The Women’s Health Initiative was even larger, involving more than 160,000 postmenopausal women. This ongoing study, which began in 1991, has consistently shown that participating in physical activity, including walking and vigorous exercise, significantly lowers the risk of heart attack and stroke in older women.12

The Best Workouts for Women

There are many great workouts for women, and the best ones for you will depend on your fitness goals and preferences. However you choose to move, there are three pillars that should be included in every woman’s fitness plan: Aerobics, strength training, and flexibility.

Here are some popular and effective workouts for women that can help to cover all your bases:

Cardio workouts. Running, cycling, swimming, and dancing are great aerobic options for increasing your heart rate, improving your overall cardiovascular health, and for burning calories. The American College of Cardiology notes that adding aerobics to your exercise plan can strengthen the heart and help it pump blood more efficiently.13

High-intensity interval training (HIIT). HIIT workouts involve short bursts of intense exercise followed by brief rest periods, making them efficient for burning calories and improving endurance, VO2 max, and the heart’s ability to pump blood throughout the body.14 As a bonus, HIIT workouts can be completed in a short amount of time. Plus, they can include either cardio, strength training, or a combination of the two.

Strength training. Weightlifting, bodyweight exercises, and resistance band workouts can help build muscle strength and tone your body. According to the American Heart Association, strength training also improves many risk factors for heart disease, including blood pressure, blood sugar, cholesterol, triglycerides, and body composition.15

Barre workouts. Barre classes combine elements of ballet, Pilates, and yoga to strengthen and tone muscles, particularly the muscles in your core, legs, and glutes. Barre workouts also offer notable cardiovascular benefits through a combination of low-impact, high-repetition movements that elevate the heart rate and engage multiple muscle groups. While not as intense as some cardio workouts, barre effectively improves endurance, stamina, and overall heart health.16

Pilates. This low-impact workout focuses on core strength, flexibility, and overall body alignment. More importantly, studies show that a regular Pilates practice boosts VO2 max levels.17

Yoga. Yoga can improve flexibility, strength, and mental well-being through a combination of poses, breathing exercises, and meditation. One large meta-analysis also found that yoga can improve heart rate variability (the variation in time between heartbeats, rather than the average number of heart beats per minute) and endothelial function. Yoga was also found to lower blood pressure, heart rate, oxidative stress, and inflammation—all risk factors for cardiovascular disease.18

Sticking with Your Exercise Routine

If you’re like most of us, you may embark on a fitness program full of motivation only to see your enthusiasm fade within a couple of weeks. Fortunately, there are some easy strategies that can help you stick to your exercise goals. First and foremost, choose activities that you enjoy. Whether it’s pickleball, Zumba, or something else entirely, you’re more likely to continue if your workouts are fun. You can also make your workouts more enjoyable by listening to your favorite tunes or podcasts. It’s also important to build accountability into your workouts, especially when you’re just beginning. Exercising with friends or working with a qualified trainer can help you stick to your fitness plan. Finally, mix up your activities to keep things interesting.

Optimize Your Heart Health Even More

Increase the heart-healthy benefits of regular exercise even more by adding an Aged Garlic Extract (AGE) supplement to your workout routine. A number of studies clearly show that AGE helps to reduce blood pressure and cholesterol while slowing the accumulation of calcium deposits and plaque in arteries.19,20 But supplementing with AGE can also support your fitness goals. A recent randomized, double-blind, placebo-controlled trial found that a daily dose of AGE improved aerobic fitness in a group of middle-aged recreational endurance athletes. Those taking AGE experienced improvements in their VO2max and aerobic power, while increasing  the amount time before experiencing muscle fatigue. Plus those who supplemented had less muscle soreness and faster post-workout recovery time. The participants in the placebo group didn’t experience any of these benefits.21

Go Girls!

Adopting a regular fitness routine can help you look and feel your best while giving your whole cardiovascular system a boost. But to reap all the benefits physical activity can provide, it’s important for women to engage in a combination of aerobic exercise, strength training, and flexibility exercises. Adding AGE to your exercise journey can enhance your cardiovascular health and fitness results even more! Just remember to consult with your healthcare provider before starting a new exercise routine, especially if you have any existing health conditions.

Hot Topic: Tips to protect your heart when Mother Earth turns up the temperature

Posted on by Brianna Swyden

How serious is it? Temperatures over 100° Fahrenheit or even temperatures in the 80°s with high humidity can cause a dangerous heat index that can be hard on the heart. Recent research published in the journal Circulation found that when temperatures reach extremes of 109° or more—something that’s not uncommon in parts of Arizona, Florida, Nevada, and Texas—the number of deaths from cardiovascular disease may double or triple.2 Another study, presented at the American Stroke Association’s International Stroke Conference suggests that the more temperatures fluctuate during the summer, the more severe strokes may become.3

How Hot Weather Affects the Heart

Because the body has to work harder than normal to maintain a healthy temperature in hot weather, your blood pressure and heart rate can go up while your blood volume can go down due to dehydration. Here’s what happens: In hot weather, the body needs to cool down. This causes the blood vessels in your skin to dilate, leading to a drop in blood pressure.2 The heart then works harder to maintain blood pressure by pumping more forcefully and faster, potentially increasing your risk of experiencing a cardiovascular event.4

Dehydration due to the heat makes matters even worse. Sweating when the weather is hot can lead to fluid loss, which can reduce blood volume and further stress the heart. 4  And that’s especially true for people who play sports or exercise in the heat. Heat stress—which occurs when the body can’t regulate its core temperature—can also cause inflammation and damage to blood vessels, which can worsen existing heart conditions.5 Even if you aren’t active when outdoors, hot weather can worsen air quality, leading to increased exposure to air pollutants that can exacerbate heart disease and may increase the risk of dying from a heart attack.6

Are You at Higher Risk? 

If you already suffer from a pre-existing heart condition, you’re even more vulnerable to these effects. This is especially true for anyone with heart failure or coronary artery disease. Studies show that the uptick in heatwaves are a significant factor in cardiovascular deaths.7 Those living with certain heart conditions or risk factors like high blood pressure and are taking certain medications like beta blockers or diuretics may be at particularly high risk during a heatwave.8,9

Age also plays a significant role. This is because, as people age, their ability to regulate their body temperature and cope with heat stress decreases.10 Even if you haven’t reached your senior years, recent studies suggest that  living in a hotter environment can accelerate your biological aging just as much as smoking does.11

Tips to Protect Your Heart in Hot Weather 

Fortunately, whether you live in Phoenix or Miami or your area is just suffering through a random heatwave, there are steps you can take to protect yourself from the heat.

1. Stay hydrated. Drinking plenty of water helps to regulate your temperature. It also helps your heart pump more easily and keeps all your organs functioning properly. Remember to drink before you are thirsty, and avoid alcohol and caffeinated beverages, which can dehydrate the body.

2. Keep cool. If you don’t have access to air conditioning, a cold compress applied to your pulse points—areas where your veins are closest to your skin’s surface, such as your wrists, neck, temples and armpits—can help you cool down.

3. Be mindful of exercise. If exercising outdoors, choose cooler times of the day and ensure you’re well-hydrated.

4. Know the warning signs of heat distress. Spending too much time in extreme heat may lead to heat exhaustion and, in turn, heatstroke, two serious heat-related illnesses in which your body can’t control its temperature.

    • Heat exhaustion symptoms. Heavy sweating, nausea or vomiting, muscle cramps, tiredness, dizziness and fainting. Treatment: Move to a cool place, loosen clothing, use cold compresses, sip cool (not cold) water. If symptoms persist, call 911.
    • Heatstroke symptoms. Fever of 104 degrees or more, severe headache, behavioral changes, confusion, hot/red skin, no sweating, rapid heartbeat and loss of consciousness. Treatment: Heatstroke is a life-threatening medical emergency. Call 911 immediately. Quickly move the individual to a cooler place, use cold compresses, do not give anything to drink.

5. Timing is everything. Avoid being outdoors during the hottest times of the day, when the sun is at its strongest and temps are at their highest—typically between 11:00 a.m. and 1:00 p.m.

6. Be aware of air pollution. Avoid outdoor activities that could expose you to high levels of air pollution during heat events.

7. Dress right. Wear loose, light-colored clothing (to help reflect heat) that is made of a lightweight, breathable fabric like cotton. Add a wide-brimmed hat, sunglasses, and sunscreen.

8. Take supplemental Aged Garlic Extract (AGE). Research shows that AGE can protect your cardiovascular system in several ways, even in the heat. Clinical trials show that AGE reduces blood pressure in patients with uncontrolled hypertension as well as common blood pressure medications.12  It’s also been shown to lower cholesterol, prevent the buildup of plaque and calcium in arteries, and even improve circulation in the skin.13,14,15,16

Being prepared when the dog days of summer hit will not only keep you comfortable in the heat, but following these tips when the temperature rises might even save your life!

How the Crosstalk Between Your Gut and Your Cells Keeps You Healthy

Posted on by Brianna Swyden

Meet the Players

You’ve likely heard of your microbiome—that collection of bacteria, fungi, and viruses that live in your gut. Over the past decade, scientists have linked the state of these gut bugs to a variety of systems in the body, including your cardiovascular, digestive, endocrine, immune, and neurological systems.2,3,4,5,6  But more recently, researchers have dialed in on the connection the microbiome has with mitochondria and how it can influence whole body health. 1

Mitochondria are the energizer bunnies of the cellular world. Found in nearly every cell in the human body, their primary job is to produce adenosine triphosphate (ATP). ATP provides the energy to drive and support many processes in living cells.7  Not surprisingly, large amounts of mitochondria are found in high-energy organs like the heart and brain.8 Along with producing energy, your mitochondria also play a role in regulating calcium inside your cells, generating heat, and triggering cell death.9,10,11

How Your Microbiome and Mitochondria Work Together

When your microbiome and mitochondria talk to each other, they influence each other’s function and contribute to many body functions through a complex network of signals. One of the primary drivers of this conversation are short-chain fatty acids (SCFAs), which are produced by the bacteria in your gut. One of the most important SCFA is butyrate, which is produced when gut bacteria ferment dietary fiber.12 Butyrate plays a critical role in gut health by acting as a primary energy source for colon cells. It also supports a healthy gut barrier and regulates gut motility. What’s more, butyrate has body-wide effects, potentially impacting inflammation, immune function, and even mental health.13 

This particular SCFA also has a positive impact on your mitochondria by enhancing its function. Butyrate can be used by mitochondria for energy production and can modulate mitochondrial activity through various signaling pathways. It also promotes the expression of your genes and the “birth” of new mitochondria.14 But dysbiosis—an imbalance between the beneficial and harmful bacteria in your microbiome—can alter mitochondrial metabolism, disrupt the creation of new mitochondria, and increase damaging oxidative stress. This can lead to impaired energy production, increased inflammation, and potentially contribute to the development of various diseases like Alzheimer’s disease and non-alcoholic fatty liver disease. 15

On the flip side, APT and a type of free radical called reactive oxygen species (ROS) are produced by your mitochondria. These can influence the microbiome, potentially affecting bacterial growth and function. But if your mitochondria aren’t working properly, it can disrupt the balance of bacteria in your gut, affecting your microbiome’s bacterial diversity and composition. Faulty mitochondria can also negatively affect the production of butyrate and other SCFAs.16 This, in turn, can trigger inflammation in the gut, which can then contribute to mitchondrial dysfunction.17 It can also negatively affect the immune system and the gut-brain axis.18,19

How to Optimize the Microbiome-Mitochondria Conversation

There’s a lot that researchers still have to learn about the two-way conversation between your microbiome and your mitochondria. Fortunately, you don’t have to have all the data to benefit from the findings so far. The following steps can help to improve both your gut and those tiny enegy factories in your cells.

Adopt a Mediterranean diet. According to findings in the journal Pharmacological Research, eating a Mediterranean diet can beneficially change the composition of gut bacteria in the elderly, and those changes can translate to an improvement in cognition and inflammation. 19 This type of eating revolves around whole foods, such as fruits, vegetables, nuts, beans, whole grains, and extra virgin olive oil. It also includes moderate amounts of fish, eggs, dairy, and lean meats.

Focus on fiber. Dietary fiber from fruits, vegetables, and whole grains provide the fiber that gut bacteria needs to ferment and produce SCFAs like butyrate.20 Strive to consume a minimum of 35 grams of fiber daily.

Try intermittent fasting. Recent evidence suggests that intermittent fasting—an eating pattern that cycles between periods of eating and intentionally abstaining from eating (fasting) on a regular schedule—can alter the composition of the gut microbiome and increase bacterial diversity while supporting mitochondrial function. This then may help improve cognition and insulin resistance. 19

Add probiotics. It’s no secret that probiotics can help balance your gut microbiome. But recent research suggests that probiotics can positively impact mitochondrial function, potentially improving energy metabolism and supporting overall health. Studies report that, not only do probiotics encourage the production of SCFAs like butyrate, they improve the creation of energy within mitochondria, promote the formation of new mitochondria, and encourage the removal of damaged mitochondria (mitophagy).21,22  Look for a shelf-stable probiotic that contains various Lactobacillus and Bifidobacterium strains and is guaranteed to be viable through the expiration date and not simply when it was manufactured. It’s also smart to search out a supplement that contains strains that have been identity-verified using DNA sequencing to ensure you’re getting the probiotic strains listed on the label.

And don’t forget prebiotics. Prebiotics supply your beneficial bacterial with the “food” it needs to thrive. They are made up of non-digestible fibers that stimulate the growth of beneficial gut bacteria. Prebiotics can also indirectly support mitochondrial health, potentially leading to improved energy production, mitrophagy, and overall cell function.23 Prebiotics can be found in many foods like apples, asparagus, bananas, barley, beans, cocoa, garlic, leeks, oats, and onions. You can also find them in synbiotics—comprehensive supplements that combine probiotics with prebiotics.

While there’s still a lot to learn about how the microbiome and mitochondria work together to enhance health, you don’t need to wait until all the intel is in to reap the benefits of this internal conversation. Eating a diet filled with nutrient- and fiber-rich foods and adding a daily probiotic/prebiotic supplement to your supplement routine can help your microbiome and your mitochondria perform at their best.

Podcast – What You Need to Know for a Healthy Heart

Posted on by Brianna Swyden

Comprehensive Cardiovascular Health and Prevention with Jim LaValle: In this episode of the Intelligent Medicine Podcast, Jim LaValle, a clinical pharmacist and heart health expert discusses various aspects of cardiovascular health in honor of Heart Health Month. The discussion covers risk factors for heart disease, including metabolic health markers and lifestyle influences. They examine the pros and cons of statins, their impact on brain health, and the role of natural supplements like Kyolic Aged Garlic Extract in cardiovascular prevention. Specific criteria for an ideal cardiovascular risk assessment are provided, and practical advice on exercise and maintaining a balanced diet is shared.

Click here to listen to Part 1 and Part 2 of this podcast.

About James LaValle

James (Jim) LaValle, R.Ph., C.C.N, is a nationally recognized clinical pharmacist, author, board-certified clinical nutritionist, with over 40 years of clinical experience in natural products, lifestyle, drug/nutrient depletion, compounding pharmacy and peptides.  LaValle is best known for his expertise in performance health and integrative care.

LaValle is also the founder of Metabolic Code Enterprises, Inc. a web platform and practice solution enterprise, launching AIR Support and the Metabolic Code Assessment.

About Dr. Ronald Hoffman

Dr. Ronald Hoffman is one of New York’s pioneering Integrative Medicine practitioners. He obtained his MD from Albert Einstein College of Medicine, and has been practicing for 34 years. His radio program, Intelligent Medicine, is the longest-running physician-hosted health program on the air.

This article is for informational purposes only. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and should never be relied upon for specific medical advice.

Effective Ways to Boost Your Exercise Performance

Posted on by Brianna Swyden

What is VO2 max?

VO2 max is the maximum amount of oxygen your body can utilize during intense exercise. And it’s the best measurement of cardiorespiratory fitness, reflecting how efficiently your heart and lungs deliver oxygen to your working muscles. VO2 max also tells you how well your muscles can use that oxygen to generate energy.

The best way to measure your VO2 max is in a laboratory setting. A tightly fitted mask or breathing snorkel is worn and connects to a bulky oxygen reading machine as the athlete exercises at full effort while working out on a treadmill, stationary bike, or rowing machine.

This machine then calculates your VO2 max based on oxygen delivery (air exchange in the lungs, pumping power of your heart, and arterial blood flow to your muscles) and also oxygen demand by the tissues in your body.

Mitochondria—those little energy factories found in every one of your cells—are a major factor in the oxygen delivery portion of VO2 max (mitochondria power the heart) and in the oxygen demand (how many mitochondria are in the muscles). In less conditioned athletes, VO2 max tends to be mostly limited by oxygen demand (less muscle mass and fewer mitochondria in untrained people). Elite athletes, on the other hand, have more muscle mass and considerably more mitochondria. So, while you can use this test to see how efficiently your body uses oxygen while you exercise, VO2 max is actually an estimate of your mitochondrial density.2

Having your VO2 max tested in a lab is the most accurate way to assess your fitness level, but it does come at a cost. Depending on your area and the facilities available, expect to spend anywhere from $100 to $250.3 However, you can also do a DIY test called the Cooper test, that can give you a good idea of where you stand fitness-wise. Also known as the 12-minute run test, the Cooper test is designed to estimate a person’s cardiovascular endurance and VO2 max. It involves running or walking as far as possible in 12 minutes. The distance covered is then used to estimate an individual’s aerobic fitness level.4

To complete a Cooper test, you should walk or run, without interruptions, for 12 minutes. You can do this on either a treadmill or running track, and you should aim to keep the same pace throughout the test. After 12 minutes, note the total distance you’ve covered. To calculate VO2 max from the distance covered in 12 minutes, enter your distance in meters (D) into the following formula: VO2 max = (D – 504)/ 45. If that feels a bit too complicated, you can simply use an online calculator like this one that gives you the option to use kilometers or miles.

What the Numbers Mean

Here are two charts that can help you figure out your cardiorespiratory fitness levels base on your VO2 max results—one for men and one for women—and your age.5

MEN Age
FITNESS LEVEL 13-19 20-29 30-39 40-49 50-59
Very weak < 2090 < 1960 < 1900 < 1830 < 1660
Weak 2090-2200 1960-2110 1900-2090 1830-1990 1660-1870
Average 2210-2510 2120-2400 2100-2400 2000-2240 1880-2090
Good 2520-2770 2410-2640 2410-2510 2250-2460 2100-2320
Excellent > 2780 > 2650 > 2520 > 2470 > 2330

 

WOMEN Age
FITNESS LEVEL 13-19 20-29 30-39 40-49 50-59
Very weak < 1610 < 1550 < 1510 < 1420 < 1350
Weak 1610-1900 1550-1790 1510-1690 1420-1580 1350-1500
Average 1910-2080 1800-1970 1700-1960 1590-1790 1510-1690
Good 2090-2300 1980-2160 1970-2080 1880-2000 1700-1900
Excellent 2310-2430 > 2170 > 2090 > 2010 > 1910

 

How to Improve Your VO2 max

If your VO2 max or Cooper test results could be better, don’t despair. You can improve your cardiorespiratory fitness with training. Focus on regular aerobic exercise, particularly

high-intensity interval training (HIIT), as well as endurance training. HIIT involves short bursts of intense exercise followed by brief recovery periods, while endurance training involves consistently pushing your endurance limits. Switching up your workouts by incorporating different types of aerobic activities (e.g., running, cycling, swimming) can help prevent plateaus and keep your body challenged.

Maintaining a healthy weight can indirectly improve your VO2 max as well, but it’s important to distinguish between gains due to training and those solely from weight loss, according to Harvard Health. And don’t forget to prioritize your recovery through adequate sleep.

Consider Supplementing

There are a number of supplements reputed to enhance exercise performance, however few have rigorous clinical evidence supporting their effectiveness. That said, there are several that studies suggest may improve VO2 max. Here are three with scientific credibility that you may want to consider adding to your workout routine.

Aged Garlic Extract (AGE) was recently shown to provide long-term performance benefits for the long distance athlete. In a double-blind, parallel, randomized study involving 75 middle-aged endurance athletes, AGE was found to boost VO2 max, increase arterial flexibility and aerobic power, decrease fatigue, and reduce post-workout recovery time. These benefits weren’t seen in those taking the placebo. The participants taking AGE also had a lower risk of cardiovascular disease compared to those in the placebo group.6

Earlier research found that AGE improves blood pressure and arterial stiffness, effectively “rejuvenating” the arteries that carry nutrient- and oxygen-rich blood to all the tissues and organs in the body, including muscles, thanks to its active compound S-allylcysteine (SAC).7 SAC is formed by the enzymatic conversion of gamma-glutamyl-S-allylcysteine (GSAC) when garlic undergoes the aging process. The result is a powerful antioxidant and anti-inflammatory compound that provides a variety of heart healthy benefits that can improve your fitness level and exercise capacity.

Ashwagandha is a popular adaptogen that some studies suggest can enhance VO2 max. During one meta-analysis, a group of Spanish researchers systematically reviewed nine studies and concluded that a daily dose of ashwagandha improved VO2 max in both athletes and healthy non-athletic people.8  This calming herb has also been found to enhance muscle strength and coordination as well as cardiorespiratory endurance.9

Rhodiola is another adaptogen that may help increase exercise performance. Research suggests that rhodiola can increase physical performance and endurance in professional athletes while helping to build new muscle tissue.10 There’s also some evidence that, when taken 60 minutes before a workout, rhodiola may improve time to exhaustion and time trial performance, which could indirectly impact VO2 max.11

If you’re an endurance athlete looking to up your game, knowing your VO2 max can provide an excellent tool to track your progress. If your VO2 max and cardiorespiratory fitness could use a boost, try focusing on HIIT and endurance workouts, maintaining a healthy weight and getting a sufficient amount of sleep. You can also take your performance to the next level with clinically proven supplements like aged garlic extract.

Stop the Bloat with Probiotics

Posted on by Brianna Swyden

Bloating is so problematic that nearly 18 percent of adults experience bloating at least once per week.1 What’s more, bloating can cause significant discomfort and even impact quality of life.2

What Triggers Bloating?

The most common underlying cause of bloating is an imbalance in gut bacteria that results in the buildup of gas in the stomach or intestines.3 This can be a result of ingesting carbonated beverages, dairy, wheat, or high-fiber foods like beans and cruciferous veggies like cauliflower or cabbage.4,5 Swallowing air while eating or chewing gum can also trigger bloating.6  Other, less common, causes include constipation, food intolerances, stomach infections, or functional gastrointestinal disorders like irritable bowel syndrome (IBS) or small intestinal bacterial overgrowth (SIBO).7,8,9

Symptoms can include:

  • Burping
  • Passing gas
  • Pain, cramps, or a knotted feeling in your abdomen
  • Nausea
  • An observable increase in the size of your abdomen (distension)9

How Probiotics Help Banish Bloat

Supporting a diverse and balanced gut microbiome with probiotics can reduce both chronic and occasional bloating. In one study review, an international team of researchers concluded that supplementing with a multi-strain probiotic could help relieve abdominal bloating and pain.10  Another review, this one conducted at the Mayo Clinic’s Division of Gastroenterology and Hepatology in Jacksonville, Florida, found that taking probiotics lessened bloating by modifying the gut microbiome.11

In a randomized double-blind study, 108 IBS patients with chronic abdominal bloating were assigned to take either a multi-strain probiotic or a placebo twice a day for four weeks. One week prior to the start of the study, and each day during the study, the participants recorded their abdominal symptoms. At the end of the study, 85 percent of the probiotic group reported satisfactory relief of their abdominal bloating compared with just 47 percent of those in the placebo group.12

While all of these studies have found that probiotics are a safe and effective treatment for bloating, it’s important to note that you might experience bloating when you first begin taking a new probiotic. This is because your gut temporarily increases gas production as it adjusts to the introduction of new bacteria. The good news is that this uptick in gas production typically subsides after a few days. What’s more, you can minimize the odds of this initial bloat by starting with a low dose of probiotics and gradually increasing the amount you take over the course of a week or two. It’s also smart to choose a probiotic that contains strains known to be effective for bloating, such as B. bifidum, B. breve, B. infantis, B. longum, L. acidophilus, and L. plantarum.13 And finally, consider taking a probiotic with prebiotics. Prebiotics feed your beneficial bacteria and reduce gas production over time.14

Other Strategies to Reduce Bloating

In addition to supplementing with probiotics, these tips can help reduce or even prevent bloating:

  • Avoid alcohol and carbonated beverages.
  • Drink more water.
  • Eat smaller, more frequent meals.
  • Focus on dietary fiber, especially if you have constipation.
  • Get more exercise.
  • Keep a food journal to help you identify bloat-promoting foods.
  • Limit caffeine.
  • Reduce your consumption of spicy, fatty, or processed foods.
  • Take a pass on candy, gum, or other foods containing sweeteners ending in “-ol,” such as erythritol, mannitol, sorbitol, or xylitol.15

If bloating is still a problem, consider trying a low-FODMAP diet. This dietary approach restricts the intake of fermentable carbohydrates known as FODMAPs. Studies show that avoiding foods that can easily ferment in the gut can reduce bloating by as much as 82 percent.16  Easily fermentable (high FODMAP) foods include beans, cruciferous veggies, garlic, onions, and wheat. According to research, omitting high FODMAP foods may be especially helpful for those who suffer from IBS-related bloating.17

Bloating is a common and potentially distressing problem. Fortunately, adding a probiotic to your daily supplement routine and adopting these lifestyle tips can help to alleviate occasional bloat and gas. But if you find that you’re experiencing bloating, gas, abdominal pain, or constipation on a frequent basis, consider talking with your healthcare provider as these symptoms may point to a more serious health problem.

Keep Calm with Ashwagandha

Posted on by Brianna Swyden

The 411 on Ashwagandha

Also known as Indian ginseng, ashwagandha is an adaptogen (herbs that help your body deal with stress, anxiety, and fatigue) with a long history of use. Native to India and Southeast Asia, ashwagandha is derived from the roots of the Withania somnifea plant. 1

Ashwagandha improves the body’s resistance to chronic stress thanks to special plant chemicals known as withanolides. Withanolides serve as important hormone precursors that morph into usable human hormones when needed. Because of this ability, ashwagandha can modulate the way hormones function during times of stress, helping to keep the body in balance.2

Science Says

In a recent review of nine randomized, placebo-controlled clinical trials involving 558 people, researchers found that supplementing with ashwagandha significantly reduced the feelings of stress, it also reduced cortisol levels.3 Here’s why that matters: When cortisol becomes chronically elevated as part of the body’s stress response, it can lead to anxiety, depression, compromised immunity, high blood pressure, and weight gain.4,5

Another systematic review took a look at seven studies investigating ashwagandha’s ability to treat chronic stress and anxiety. A total of 491 adults were randomized to take ashwagandha or placebo for six to eight weeks. Overall, the studies found that ashwagandha significantly lessened both stress and anxiety levels, reduced sleeplessness and fatigue, and decreased serum cortisol levels when compared with placebo.6

Earlier research also shows strong evidence of ashwagandha’s stress-busting abilities. For instance, a 2012 randomized, double-blind trial of 64 volunteers with a history of frequent stress reported significant benefits in those taking the herb. Each participant was given either ashwagandha or a placebo. After 60 days, stress surveys in those taking ashwagandha indicated an average 76 percent drop in the physical symptoms of stress, a 69 percent reduction in stress-related insomnia, 68 percent less social dysfunction, and a 79 percent improvement in depression. Cortisol levels also fell significantly. Those in the placebo group experienced only negligible improvement.7

Bonus Benefits

For anyone experiencing chronic stress, insomnia and brain fog are no strangers. Stress activates something called the hypothalamic-pituitary-adrenal (HPA) axis, which regulates your stress response by releasing hormones like cortisol that can negatively affect your ability to fall asleep or stay asleep.8 But studies show that, thanks to ashwagandha’s ability to tame stress, the herb can improve insomnia and sleep quality.9,10

Stress, or more accurately high cortisol levels, can also interfere with brain function, impairing memory, concentration, and cognitive processing.11 Fortunately, researchers from Texas A&M University and the University of Wisconsin have found that taking ashwagandha for just 30 days improves cognitive flexibility, visual memory, reaction time, psychomotor speed, executive functioning, and a person’s stress response.12

Other studies suggest that ashwagandha also decreases inflammation, acts as an antioxidant, and may have the potential to increase muscle mass and strength.13,14,15  If that wasn’t enough, this multitasking herb might also raise testosterone levels and improve male fertility.16

What to Look For

When choosing an ashwagandha supplement, look for a standardized full-spectrum bioavailable product that contains the roots of the Withania somnifea plant, not the leaves. The roots contain the highest concentrations of withanolides. What’s more, the roots have been more extensively researched.17 It’s also wise to choose a supplement from a trusted company based on scientific research.

Safety Considerations

Ashwagandha is considered safe for most people. That said, avoid supplementation if you’re pregnant or breast-feeding. And because the herb may interact with certain medications, always check with your healthcare provider before use.18

When life gets crazy, it’s a good idea to take a deep breath and reach for herbal help to tame those stressful feelings. Ashwagandha has a proven track record of easing the symptoms of stress, improving sleep, and helping you stay sharp, even when life becomes challenging.

CoQ10 for a Healthier Heart

Posted on by Brianna Swyden

Coenzyme Q10, more commonly known as CoQ10, is a fat-soluble, energy-producing micronutrient that’s found in nearly all of your tissues, with some of the greatest concentrations found in your heart.1 And that matters because this hard-working organ needs lots of energy to function at its best.

CoQ10 Loves Your Heart

Research suggests that CoQ10 acts like a valentine for your heart. It improves heart function, reduces the risk of heart disease, and helps manage conditions like congestive heart failure by warding off oxidative stress and supporting energy production within heart cells.2 

This multi-talented molecule neutralizes harmful free radicals by contributing an electron to damaged molecules that are missing one (normal molecules have two electrons).3 This, in turn, helps to prevent oxidative damage and inflammation—two factors that contribute to the development of atherosclerosis.4

This powerful antioxidant also helps to generate energy inside your mitochondria (structures inside your cells that act like little energy factories) by making another antioxidant called adenosine triphosphosphate (ATP). ATP is the primary energy source for the heart. In fact, some experts have even dubbed CoQ10 “the body’s spark plug.” The production of ATP directly impacts the heart’s ability to effectively pump blood and maintain adequate cardiac output. If ATP levels drop, so does your heart’s ability to contract properly. That can lead to reduced cardiac output and ultimately contribute to heart failure.5

Lagging Levels

 Although CoQ10 is vital to a healthy cardiovascular system, the body’s production of this critical molecule naturally falls as we age. And that can increase oxidative stress in those over age 60.6   Another common reason for low levels is the use of statin drugs. This happens because these cholesterol-lowering medications decrease LDL cholesterol levels, which is the main transporter of CoQ10 in the blood.7  Whether you’re taking a statin or are simply growing older, low levels can have a significant impact on your cardiovascular system. Indeed, three out of four patients with heart diseases have subpar CoQ10. 2  Fortunately, supplementing with CoQ10 can help restore your levels.

What the Science Says

 How effective are CoQ10 supplements for cardiovascular health?  Multiple studies show that supplementation can help those with congestive heart failure, especially when paired with conventional treatment. In an Italian study of more than 2,600 people with heart failure, adding a daily dose of CoQ10 to their standard treatment significantly improved symptoms like swelling and heart palpitations.8 And a review of 14 randomized clinical trials involving 2,149 heart failure patients also found that those taking CoQ10 had less chance of dying prematurely. They also had a higher tolerance for exercise compared to the participants taking a placebo.9 That’s a big deal since regular exercise is one of the most effective ways to support a healthy heart.

CoQ10 has also been found to promote healthier blood pressure, due largely to its antioxidant activity. It’s so effective that one randomized, double-blind, placebo-controlled study conducted by the Department of Veterans Affairs found that supplementing with CoQ10 for three months effectively reduced systolic blood pressure.10 Australian researchers noted even better results after reviewing 12 clinical trials of people with hypertension. In their analysis, they found that supplementing with CoQ10 lowered systolic blood pressure by as much as 17 mm Hg and diastolic blood pressure by up to 10 mm Hg without any significant side effects.11

Better Together

As good as CoQ10 is on its own, it’s even better when taken with Aged Garlic Extract (AGE). This dynamic duo has been shown to reduce inflammation, improve vascular elasticity and endothelial function, and help prevent the progression of coronary atherosclerosis. In one groundbreaking study conducted at the Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, researchers looked at a group of 65 firefighters who were at an elevated risk of cardiovascular disease. Firefighters, who work in a highly stressful environment, have triple the risk of having a heart attack or other adverse cardiovascular event compared to the general population.

All of the firefighters underwent testing to determine their risk by measuring pulse-wave velocity (which evaluates the elasticity of arteries) and digital thermal monitoring (which measures endothelial function). The researchers also took an earlier study into account that measured each firefighters’ plaque buildup and the amount of calcium deposits in their coronary arteries, as well as systemic inflammation—all factors that can increase the risk of heart attack.

Once their risk factors were determined, the firefighters were randomly assigned to either a daily supplement containing AGE and CoQ10 or a placebo. After one year, the researchers found that, compared to the placebo, the AGE/CoQ10 combo improved both vascular elasticity and endothelial function. That, in turn, helped lower the odds of future plaque buildup and reduced the firefighter’s risk of a future heart attack or stroke.12,13

Fortunately, you don’t need to have a high-pressure job like firefighting to benefit from AGE and CoQ10. If you’re at an increased risk of atherosclerosis, heart failure, or high blood pressure—or if you’re taking a statin drug—supplementing with these two powerhouse nutrients can help your entire cardiovascular system keep the beat for a lifetime.